Journal of the Royal College of Physicians of Edinburgh最新文献_第2页

Atypical femur fracture following romosozumab and bisphosphonate treatment. 罗莫单抗和双膦酸盐治疗后的非典型股骨骨折。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2024-11-23 DOI: 10.1177/14782715241301487

Mark Jacunski, Hanna Johnsson, Stuart H Ralston, Barbara Hauser

{"title":"Atypical femur fracture following romosozumab and bisphosphonate treatment.","authors":"Mark Jacunski, Hanna Johnsson, Stuart H Ralston, Barbara Hauser","doi":"10.1177/14782715241301487","DOIUrl":"10.1177/14782715241301487","url":null,"abstract":"Romosozumab, a monoclonal antibody against sclerostin, is a newly licensed dual-acting osteoporosis treatment for patients at very high risk of fracture. Sclerostin inhibition leads to stimulation of bone formation and simultaneous inhibition of bone resorption. Only three cases of atypical femur fractures were reported out of 5,621 patients who received romosozumab in the pivotal randomised controlled trials FRAME and ARCH; however, most enrolled clinical trial patients were osteoporosis treatment-naïve or had a prolonged washout period. We report a case of an atypical femur fracture that occurred after the completion of romosozumab treatment which was followed by one dose of 5 mg intravenous zoledronic acid. The patient had previously received a 2-year course of subcutaneous teriparatide and subsequent three consecutive yearly intravenous zoledronic acid infusions, followed by a 2-year treatment break. This case highlights the risks of prolonged suppression of bone resorption, which includes romosozumab due to its dual action and the need for further research on how to minimise such deleterious medication effects. Patients who are switched from prolonged antiresorptive treatment to romosozumab, should be risk-assessed and counselled for the risk of atypical femur fracture.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"19-22"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Secondary haemophagocytic lymphohistiocytosis associated with scrub typhus: A case report with a brief review of literature. 与恙虫病相关的继发性噬血细胞淋巴组织细胞增多症：1例报告并简要复习文献。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2024-12-08 DOI: 10.1177/14782715241303969

Rupak Chatterjee, Atanu Chandra, Sumana Mukherjee, Nandini Chatterjee, Sugata Dasgupta

{"title":"Secondary haemophagocytic lymphohistiocytosis associated with scrub typhus: A case report with a brief review of literature.","authors":"Rupak Chatterjee, Atanu Chandra, Sumana Mukherjee, Nandini Chatterjee, Sugata Dasgupta","doi":"10.1177/14782715241303969","DOIUrl":"10.1177/14782715241303969","url":null,"abstract":"Scrub typhus is a very important cause of acute undifferentiated febrile illness in the Asia-Pacific region. Haemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening condition characterised by widespread immune system activation, resulting in tissue damage throughout multiple organ systems. HLH is categorised into primary HLH, arising from intrinsic defects in lymphocytes and macrophages, and secondary HLH, primarily triggered by infections or connective tissue disorders. HLH is one of the rarest complications of scrub typhus. We present the case of a previously healthy young man who presented to our facility with a history of acute febrile illness. Clinical examination revealed an eschar and subsequent laboratory investigations confirmed the diagnosis of scrub typhus. The patient's haematological parameters showed pancytopenia, raising suspicion of this rare association. Confirmatory tests established the diagnosis of HLH, and the patient achieved an uneventful recovery following treatment for the underlying illness and supportive care.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"23-27"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thanks to Reviewer. 感谢审稿人。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2025-01-29 DOI: 10.1177/14782715251316448

引用次数: 0

Cranio-vertebral junction tuberculosis: Uncommon presentation of a common disease. 颅椎交界处结核：一种常见疾病的罕见表现。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2024-11-29 DOI: 10.1177/14782715241302224

Souradeep Chowdhury, Surabhi Vyas, Upendra Baitha, Pankaj Jorwal, Manish Soneja, Amandeep Singh

引用次数: 0

Why do doctors use AI in healthcare? 为什么医生在医疗保健中使用人工智能？

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2024-12-11 DOI: 10.1177/14782715241306146

Abeera Junaid, Tamsin Adhiyaman, Nithin Fernando Edwin, Vedamurthy Adhiyaman

引用次数: 0

Do low-risk patients really need follow-up after a pulmonary embolism? 低危患者在肺栓塞后真的需要随访吗？

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2025-01-08 DOI: 10.1177/14782715241311959

Lesley Alexander, Susan Burnie, Catherine Rossiter, Chris Isles

{"title":"Do low-risk patients really need follow-up after a pulmonary embolism?","authors":"Lesley Alexander, Susan Burnie, Catherine Rossiter, Chris Isles","doi":"10.1177/14782715241311959","DOIUrl":"10.1177/14782715241311959","url":null,"abstract":"Background: The British Thoracic Society recommend that pulmonary embolism (PE) patients with low-risk Pulmonary Embolism Severity Index (PESI) scores are considered for outpatient (OP) management, in settings where robust pathways for follow-up and monitoring exist.Methods: Retrospective cohort study. We reviewed the electronic records of 109 consecutive PE patients considered appropriate for OP management. Primary outcomes were the incidence of recurrent venous thromboembolism, major bleeding, mortality at 1 year and evidence of chronic thromboembolic pulmonary hypertension (CTEPH).Results: Low-risk PESI scores (I-II) were recorded in 78 (72%) patients, with higher scores a consequence of age and comorbidity rather than haemodynamic instability. There was a low rate of adverse outcomes despite a lack of formal follow up for most patients. There was no evidence of CTEPH in 34 patients who underwent echocardiography.Conclusion: Our analysis challenges the need for robust follow-up pathways for all patients with pulmonary embolism.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14-18"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A rare presentation of neurofibromatosis mimicking leprosy. 罕见的神经纤维瘤病，类似麻风病。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2025-01-17 DOI: 10.1177/14782715241313420

Sonika Garg, Arpita Nibedita Rout, Chandra Sekhar Sirka, Bevan Priyadharshan

引用次数: 0

Delirium assessment, management and barriers to effective care across Scotland: A secondary analysis of survey data from World Delirium Awareness Day 2023. 苏格兰全境谵妄评估、管理和有效护理障碍：对2023年世界谵妄意识日调查数据的二次分析

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2024-11-29 DOI: 10.1177/14782715241301486

Fariha Naeem, Rose S Penfold, Roy L Soiza, Rebecca Von Haken, Heidi Lindroth, Keibun Liu, Peter Nydhal, Terry J Quinn

{"title":"Delirium assessment, management and barriers to effective care across Scotland: A secondary analysis of survey data from World Delirium Awareness Day 2023.","authors":"Fariha Naeem, Rose S Penfold, Roy L Soiza, Rebecca Von Haken, Heidi Lindroth, Keibun Liu, Peter Nydhal, Terry J Quinn","doi":"10.1177/14782715241301486","DOIUrl":"10.1177/14782715241301486","url":null,"abstract":"Introduction: Delirium is a common, severe neuropsychiatric syndrome in hospitalised older adults. We evaluated use of validated delirium assessment tools, adherence to national guidelines and prevalence and management of delirium across Scotland, identifying barriers to effective care.Methods: Secondary analysis of national survey data, collected by participating clinicians on World Delirium Awareness Day (15 March 2023).Results: Among 120 responses (3,257 patients), the 4AT was the most frequently used assessment tool (75%), while 14% of units reported using clinical judgement alone. The delirium assessment rate was 74%, with a prevalence of 22% at 8 am. Management protocols varied, with frequent routine non-pharmacological interventions including pain management (88%), hydration (87%) and open family visiting (80%). Barriers to delirium care included insufficient staffing and training.Conclusion: While many hospital settings follow national delirium guidelines, some still rely on clinical judgement for assessment, with variability in management protocols and practices. We have highlighted key barriers to effective delirium care in Scotland.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"6-13"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cutaneous larva migrans outside the tropics - A clue to global warming? 皮肤幼虫迁徙到热带以外——全球变暖的线索？

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2024-12-27 DOI: 10.1177/14782715241310288

David Bernal-Bello, Pedro Gallego-Torrero, Alejandro Morales-Ortega

引用次数: 0

Corridor care: Everywhere and anywhere. 走廊关怀：无处不在，无处不在。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2025-02-10 DOI: 10.1177/14782715251319951

Clare Bostock

引用次数: 0